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一篇叙述性综述:探讨促卵泡素δ个性化给药算法用于卵巢刺激的效率以及生殖和临床结局。

A Narrative Review Discussing the Efficiency of Personalized Dosing Algorithm of Follitropin Delta for Ovarian Stimulation and the Reproductive and Clinical Outcomes.

作者信息

Doroftei Bogdan, Ilie Ovidiu-Dumitru, Anton Nicoleta, Marcu Olivia-Andreea, Scripcariu Ioana-Sadyie, Ilea Ciprian

机构信息

Faculty of Medicine, University of Medicine and Pharmacy "Grigore T. Popa", University Street, no 16, 700115 Iasi, Romania.

Clinical Hospital of Obstetrics and Gynecology "Cuza Voda", Cuza Voda Street, no 34, 700038 Iasi, Romania.

出版信息

Diagnostics (Basel). 2023 Jan 4;13(2):177. doi: 10.3390/diagnostics13020177.

Abstract

Follitropin delta is the third recombinant human follicle-stimulating hormone (r-hFSH) expressed in a host cell line of human fetal retinal origin that currently emphasizes that the actual tendency of administration is a personalized dosing algorithm based on the anti-Müllerian hormone (AMH) and body mass index (BMI) for ovarian stimulation. In this context, we aimed, in the present manuscript, to gather all available data published between 2018-2022 regarding the co-administration and administration of follitropin delta and the clinical outcomes reported following an in vitro fertilization (IVF). Follitropin delta is non-inferior in contrast to its previously launched agents for ovarian stimulation, enhancing a similar-to-superior response reflected by both the reproductive and pregnancy outcomes in parallel with a low risk of ovarian hyperstimulation syndrome (OHSS), being well tolerated. The body weight and AMH level are factors that may influence the outcome in a patient. Despite controversy and results that refute these arguments on several occasions, follitropin delta exceeds the benefits of conventional dosing with either follitropin alfa or follitropin beta. Thus, all post hoc, derived analyses and subsets of patients that participated in subsequent studies support this statement. Despite the relatively limited spectrum of data in the current literature, most authors brought potent proof, supporting the subsequent use of this drug depending on the patient's profile and overcoming ethnic-related limitations. Although others contradict these observations, this topic and drug possess substantial potential, which is why additional studies are mandatory to fill the existing gaps in our knowledge and expand these experiences at a larger scale supported by the obtained reproductive and clinical outcomes that clearly indicate an overcoming of all limitations.

摘要

注射用重组人促卵泡激素Δ是第三种在人胎儿视网膜来源的宿主细胞系中表达的重组人促卵泡激素(r-hFSH),目前强调实际给药趋势是基于抗苗勒管激素(AMH)和体重指数(BMI)的个性化给药算法用于卵巢刺激。在此背景下,在本手稿中,我们旨在收集2018年至2022年间发表的所有关于注射用重组人促卵泡激素Δ联合使用及单独使用以及体外受精(IVF)后报告的临床结局的可用数据。与先前推出的用于卵巢刺激的药物相比,注射用重组人促卵泡激素Δ并不逊色,在生殖和妊娠结局方面均表现出相似至更优的反应,同时卵巢过度刺激综合征(OHSS)风险较低,耐受性良好。体重和AMH水平是可能影响患者结局的因素。尽管存在争议且有多次反驳这些观点的结果,但注射用重组人促卵泡激素Δ的益处超过了使用促卵泡激素α或促卵泡激素β传统给药的益处。因此,所有参与后续研究的事后分析、衍生分析和患者亚组均支持这一说法。尽管当前文献中的数据范围相对有限,但大多数作者都提供了有力证据,支持根据患者情况随后使用这种药物并克服种族相关的局限性。尽管其他人反驳这些观察结果,但这个主题和药物具有巨大潜力,这就是为什么必须进行更多研究来填补我们现有知识的空白,并在获得的生殖和临床结局的支持下更大规模地扩展这些经验,这些结局清楚地表明克服了所有局限性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/978d/9858569/eae619a5cd7c/diagnostics-13-00177-g001.jpg

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